Exodus Of Filipino Health Professionals

JAMS sent me email yesterday and this article as attachment, saying ‘I am a UP alumnus who has decided to migrate to the US late in my life.I have written this article about myself and what made me decide to make this radical move. Please send me the article of Mr James Fallows to further enlighten me about our culture. ¶ My family and I are starting out a new life in Sacramento as of now.’ Note the year of writing: 2006. With minor editing – Frank A Hilario, 08 April 2007

When President Manuel L Quezon uttered the CURSE that he would rather see the Philippines run like hell by Filipinos than being in heaven under foreign rule, he must have prayed for hell to last just one generation. We are living in the fifth generation since Quezon’s rhetoric, and no Filipino believes we are in heaven or in purgatory at this point. Is there a way to reverse this CURSE?

My generation is the PARENT of today’s. We were the MASA that made EDSA 1 possible. At that time, everything was either black or white. We saw Marcos as all evil, and Tita Cory and her cohorts as all good. Many health professionals opted to stay, witness, and enjoy the transformation from the “dark” Marcos years to real, honest-to-goodness “prosperity” for the Philippines. Many health professionals, already comfortable in other countries, opted to come back and practice here. Damn the coups, those were just birth pains.

The next decade, however, proved apocalyptic. The 90s saw post-Marcos Philippines lag behind other ASEAN tigers, and now is considered its basket case. After the coups came the big whammies, Mt. Pinatubo and other calamities, the electric power crisis and the killer 1997 Asian crisis. On hindsight, how our leaders handled the coups was but a harbinger of how they would handle bigger crises. The recovery efforts engineered by our leaders were really bungled. The Asian crisis seemed to level the playing field among the ASEAN nations; however, while our neighbors closed ranks and fought the crisis as a nation, the Filipino leaders were just too blinded with self-interest and too busy politicking.

The 1997 Asian crisis saw the retirement investments of health professionals reduced by more than half in just the blink of an eye. We never felt any recovery since. We felt betrayed. We worked hard, offered our talents to the Filipino people for a pittance, only to realize that all the “evils” we abhorred in the Marcos regime never really left our shores with his exile. The very reasons the Philippines “stagnated” then are still the reasons why we continually fall behind our ASEAN neighbors. There is no more Marcos to blame for the ills of our nation. The Filipino political leaders today are really made of the same mold as that of Marcos. Sadly for the rest of the Filipinos, business and politics are but two faces of the same coin.

When I first entered the workforce in the 80s, choices were simpler for me. I was young, talented, and the mood was upbeat. Money then was not at the top of my priorities, rather that I could make a difference in this country by positioning myself in the countryside where my expertise would be needed most. Now, in the first decade of this millennium, choices have become more complicated. My kids are growing fast. My investments in educational plans are now worthless. Will I be able to afford sending all of them through medical school? Our house has been under construction for 6 years now, and it is not yet done. What if somebody in the family gets sick? Will I be able to afford a heart bypass? Will I be able to save enough to have a comfortable retirement for my wife and myself? My eldest son was scared shit while being held up alone as the FX cab he rode traversed España near UST in Manila just for his cell phone and some petty cash; my second son was just lucky to be in another exit of a town mall when a bomb exploded in one of the exits on Valentine’s Day of 2005 in General Santos City, the second of two bombings in two months. When the wife of the most “maka-masa” physician in our city got kidnapped, I asked, who is safe? Even if I don’t like to admit, MONEY, not a lot but just enough to get by, is now among my top priorities. TIME is not on my side now.

Why should I be in this position? I serve my country in my own small way. I give my best to my patients, without regard for their pocketbook. I teach younger doctors in residency training to become ENT, head and neck surgeons. I actively participate in community development, short of entering politics myself. I am a nationalist.

As I saw our institutions crumble with disunity, corruption and self-interest, I told myself, this is NOT yet the end of it. Whose time is it this time? How much beating can the Filipinos endure? When will salvation finally come? At the rate we are going, the worst is yet to come. I do not see real development for the Philippines in my lifetime anymore, and not even in my children’s lifetime. Does it still make sense for me to stay behind? Knowing that the opportunities here have become so meager, does one become less a Filipino if one leaves for another land and in the process repatriate some dollars to help the country survive? Is it wrong to think of self preservation, do it in a clean and honest manner in a country with better opportunities, and then help save the Philippines by sending back some cash? Will the money I repatriate back to the Philippines better serve my country than the expertise I can render as an ENT, head and neck surgeon to my countrymen?

When I retooled to become a nurse at my age, status and expertise, I tried to keep it secret; but in just a few days, the whole medical community in our city buzzed with the news. Within weeks, more than half of the doctors actively practicing in our city were into Nursing. I realized that many nationalist friends, who were with me in the Snap Elections, in the medical team for Mendiola during the original EDSA revolution, were as confused and frustrated as I was with what had become of post-Marcos Philippines. One of them, the most left-leaning who is now a very successful doctor and businessman (his story jokingly referred to as “from communist to capitalist”), still has not gone over the agony of this “painful” decision. Retooling via the Nursing route just shows that most doctors do not have US$200,000 to get an investor’s visa – an amount which may be peanuts to the leaders of our country, just in case they need to leave in haste.

What is happening in the health community is but a microcosm of what is happening in the middle class. We see massive retooling of intelligent accountants, engineers, teachers, lawyers, dentists, managers, etc attuned to the services currently in demand for overseas placement. Suddenly there is a huge opportunity OUTSIDE of the control of Filipino politicians-cum-businessmen. In the next decade, we shall be seeing a hemorrhagic migration of the middle class, including the cream of the middle class, the health professionals. These are the Filipinos who are now in their 30s and 40s, successful in their own right, who dream big, work hard, and hope against hope that real prosperity will come to the Philippines within their lifetime. This is the real reason why people-power politics is on the wane – the middle class is just too busy retooling for this BIG opportunity, and with no clear choices, they just cannot give a damn at this point!

Is there something good coming out of this hemorrhage?

In the short term, YES. The retooling and migration of our brightest in practically ALL fields opens up opportunities, which are locked with them while they stay. Those who opt to stay shall rise up and grab these vacated opportunities. Fresh capital sent back by the migrants creates new opportunities enjoyed by all sectors. In the health sector, it is observed that most patients get operated only if there is remittance coming from abroad. The record remittance last year of more than $10 billion is not just due to sheer number of Filipinos working abroad, but the quality of the jobs they take.

In the long term, IT DEPENDS. We are witnessing the birth of globalization. We see people getting their income from another country and investing in another. Technology has made the world smaller. The Filipinos, with about 1 million able-bodied adults having left the country in 2005 alone, is at the crest of this globalization phenomenon. In effect, while our politicians bicker, the Filipinos, forced by circumstance, silently lead the country to become a global nation. We are being global citizens providing various kinds of service jobs practically anywhere in the world, using our God-given traits like facility of language, sense of humor, intelligence, respect for the elders, humility, adaptability etc.

With globalization comes SPECIALIZATION. In effect, the vision of the Philippines as a self-contained country just shows our naiveté. We always perceive our country to be rich in natural resources, but who rules the world? Corporations and nations who are run like corporations rule this world. Nations run like hell stay rotten in hell. We waste precious dollars protecting industries that cannot compete with China or India. Instead we must specialize in endeavors where our natural resources and talents set us apart in this world. What are we good at? Service providers are now among the most sought after resources worldwide. We are among the best seafarers, teachers, nurses, caregivers, singers, entertainers, doctors, managers, IT professionals, engineers, carpenters, plumbers, craftsmen, cartoonists etc. We have a rich human resource that needs RETOOLING to be competitive in the world market. Even with one million workers going out last year, millions are still unemployed and underemployed. In agriculture, we must concentrate on products where we can be net exporters and import products being produced cheaper in other countries. In Southern Mindanao, for instance, the reason insurgency and banditry have been minimized in the recent past is not military might but opportunities in agriculture. Battlefields before are now growing bananas for export, rice in thousands of hectares of newly irrigated rice fields in Maguindanao, and Lake Buluan now teeming with fish pens. The Philippines possesses some of the most beautiful terrains and beaches in the world. We have a culture rich in merry-making all year round. Tourism nurtures natural resources as it creates new opportunities.

At this point, we are witnessing the worst among our leaders and the Filipinos in general. The pervading sense of hopelessness is growing. We grieve about the exodus of our middle class, especially the health professionals. However, this catharsis is the final blow that will forge the resolve of the Filipinos to rise and claim our rightful place in this planet, the final “oracion” to reverse Quezon’s curse. When the dust settles, leaders will finally realize that the expatriate Filipinos have actually opened the way for the Philippines to be a global nation. And rightly, for the country to remain relevant to the global Filipino, our leaders must endeavor for the Philippines to become an attractive home for the global Filipino to keep.

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2 Responses to “Exodus Of Filipino Health Professionals”

is exodus of filipinos for foreign employment a blessing or a curse to this country? what are the immediate practical strategies or approaches do you recommend to mitigate the dysfunctional consequences this phenomenon brings in the aspect of delivery of services and in the long term national development?

To stop the hemorrhage, or at least reduce it, educate people to become entrepreneurs so that they can create jobs for themselves – and others. Let the government help families become entrepreneurs. Villar once promised to push for 1 million entrepreneurs among Filipinos – now he is only pushing his own agenda.